In their final conversation in this round of Sex Talk, Dr. Hilda and Dr. Pat talk about what it takes to keep a long-term relationship—straight or gay—sexually energized, and why it’s worth it. 

Dr. Pat: I have lots of gay couples in my practice, and I think their issues are very similar to the ones that longstanding heterosexual couples have. That all couples have.

Dr. Hilda: They get in a rut like everyone else and need to do something to spice it up.

Dr. Pat: And their relationships get rocky just like all relationships and may end.

Dr. Hilda: They get older, and they have dry vaginas and they have pain and discomfort. So I think most of the topics that we’ve talked about would apply equally whether your partner is male or female.

Dr. Pat: I think when an older gay woman loses her partner through death or the end of the relationship, it must be as hard for her to find a lover as it is for a heterosexaul woman.

Dr. Hilda: The biggest issue I’ve heard from gay women who are aging is something called Bed Death, where they both lose libido. The hormones are going down, their estrogen is going down, the testosterone is going down in both women at the same time, so neither one of them has a libido. Then what do you do? The advice is pretty much the same that I would tell a heterosexual couple: look for something that brings some spice back into the bedroom. Your largest sex organ is your brain, so bring in erotica, for instance, whether it’s something that you read to each other or a video that you watch. It’s something that stimulates the brain.

Dr. Pat: If you have no libido, if neither of you have any libido, how are you going to like get a libido—read the erotica?

Dr. Hilda: You have to force yourself to do it. You have to make it a priority. Otherwise you just go to bed every night, and pretty soon you start to resent each other. So you have to make it a priority.

Dr. Pat: But in a situation like that, you’d also see if there are any health issues, right? Whether an estrogen cream would be useful, for instance

Dr. Hilda: Absolutely. You certainly look for health issues and medications—

Dr. Pat: Depression.

Dr. Hilda: —depression, and all that. Once you rule out all of that, I usually go for the brain. I usually try something like erotica first. I try hormones later, because these days most women don’t really want to go the hormone route unless they have to.

Dr. Pat: But I’m talking about external genital estrogen that is topical. Because when a woman has  a dry clitoris and a dry vagina, it’s is often  unpleasant for her to be touched.

Dr. Hilda: That’s true. I was thinking more on the libido end than the pleasure end, but it is true that if you can increase pleasure, you’re going to increase libido. But usually I tend to separate the two and try to deal with the libido side and then deal with the pleasure side. Because certainly if your vagina and your clitoris are sore because your estrogen is low, you’re not going to want to have sex. So you need to approach the libido-brain connection as well as the physical side—the vulva, the vagina—and make sure those are healthy.

Dr. Pat: Outside the bedroom, if there can be a conscious effort on the part of a couple to do something romantic—something that takes less effort, perhaps, than reading a book aloud. Maybe taking a little weekend sexcation, going for an autumn ride in a Central Park gondola—having a drink, just walking through the park. Taking time for joy.

Dr. Hilda: Or checking into a sleazy hotel.

Dr. Pat: And getting bedbugs. [Laughter]  Don’t laugh!

Dr. Hilda: Pat, you take a sleeping bag!

Dr. Pat: Oh, God. No thank you.

Dr. Hilda: It’s so exciting. It’s so naughty.

Dr. Pat: I’d rather sleep in Central Park.

Dr. Hilda: It’s so naughty.

Dr. Pat: No, bedbugs are not naughty. I will sleep in Central Park before I will sleep in a sleazy hotel.

Dr. Hilda: Well, that’s a thought:  Have sex in Central Park—

Dr. Pat: Right, just next to the gay guys.

Dr. Hilda: —behind the bushes. In the Rambles.

Dr. Pat: Be murdered. Be part of a new crime series.

Dr. Hilda: (laughing) I actually think this is helpful because it recaps a few of the points that we started with in the first conversation. Not sex in The Rambles, but things to look out for when you’re sexually active these days.

Dr. Pat: You’re right. And looking back over the topics we’ve covered, I think part of what’s come through here is women maintaining a sense of themselves as sexual beings throughout the life span. Not just with a partner, and not just as they’re going through menopause, or as a way of coping with menopause, but through the life cycle. And the takeaway is that there’s no real reason for women not to remain orgasmic.

Dr. Hilda: Absolutely. As long as you’re breathing, you should be having sexual pleasure. And it should never end. For women, there’s no reason for it to end.


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